Accordia Healthcare LLC
Organization Active NPI Primary Care Clinic/Center · Vidalia, GA
NPI 1962826511 · NPPES record last updated Feb 18, 2014
Key facts
- NPI
- 1962826511
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- License
- 68199 (GA)
- Legal business name
- ACCORDIA HEALTHCARE LLC
- Practice address
- 3193 E 1St St
Vidalia, GA 30474-8830 - Phone
- (912) 537-8588
- NPI assigned
- Feb 18, 2014
- Organization subpart
- No
Authorized official
- Name
- John Welch
- Title
- Owner
- Phone
- (912) 245-0379
Practitioners 28
-
Bambi Ivey Allen, FNP
-
Cynthia Jill Martin Clark, FNP-C
-
Matthew Davis, M.D.
-
Lindsay Fowler Dowis, D.O.
-
Chasity Evans Fraley, APRN
-
Jenna Rubin Franz, FNP
-
Heather Hawn Fry, NP-C
-
Kristen Nicole Helton, FNP-BC
-
Desha H Jones, FNP-C
-
Jessica Leigh Langenfeld, FNP-C
-
Pamela Williams Lindsey, NP-C
-
Susan J Montford, ARNP, FNP-C
-
Avery Seelhammer, FNP
-
Jennifer Lynn Smith, FNP-C
-
Arlie Stevens, FNP-BC
-
Dorothy Bre'Anna D Thomas, FNP-C
-
Anissa Dawn Triplett, FNP
-
Lanie Welch, FNP-C
-
Margaret Rene Williams, N.P.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140523001143 | GA | Part B Supplier - Clinic/Group Practice | 1153544945 |
Receives reassigned benefits from 27 practitioners Practice locations: Canton, GA; Dublin, GA; Statesboro, GA; Vidalia, GA; Warner Robins, GA |
National Provider Directory
Locations
1100 Hillcrest Pkwy
Ste A8
Dublin, GA 31021
Phone (478) 205-8312
2201 Veterans Blvd
Dublin, GA 31021
Phone (478) 205-5312
3780 Northside Dr
Ste 130
Macon, GA 31210
Phone (478) 475-1600
1301 Statesboro Place Cir
Ste 300
Statesboro, GA 30458
125 Church St
Ste 200
Vidalia, GA 30474
Phone (912) 274-6010
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | 68199 | GA | Yes |
Addresses
Primary practice location
3193 E 1St St
Vidalia, GA 30474-8830
Mailing address
125 Church St
Ste 200
Vidalia, GA 30474-4770
Phone (912) 245-0379
Other providers in Vidalia, GA
All providers in Vidalia, GA · Primary Care Clinic/Center in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 18, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.